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CPT code 23065: Shoulder biopsy, deep soft tissue2026 Medicare rate & RVUs in Houston, TX

Report this code for an open biopsy of deep soft tissue in the shoulder region when tissue is sampled for diagnosis rather than completely excised.

CMS RVU26DEffective Oct 1, 2026One payment locality276 Medicare services in 2024

In Houston, TX, Medicare pays $235.45 for 23065 in the office and $151.20 when it’s performed in a hospital or facility.

$235.45Office (non-facility)
$151.20Hospital or facility
+1.7%vs the national office rate ($231.47)

Check a contract rate as a % of Medicare · 23065 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 23065 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 23065 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 23065 covers

This service involves surgically obtaining a tissue sample from deep soft tissue in the shoulder region, such as a deep soft-tissue mass. The surgeon makes an incision to reach the target and removes tissue for diagnostic examination; the procedure is a biopsy, not complete removal of a lesion. Orthopedic surgeons and other surgeons who evaluate shoulder-region masses may perform it in an outpatient operating room or hospital setting.

Select the code when the sampled structure is deep shoulder soft tissue. A record supporting the claim identifies the target and its location, documents the approach and tissue obtained, and distinguishes sampling from complete excision. The code has a 10-day global period, so related postoperative visits during that period are included. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Houston, TX compares for 23065

Across 109 of 109 payment localities, the office rate for 23065 runs from $205.36 in Arkansas to $298.35 in San Benito County, CA. Houston, TX pays $235.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

23065 in Houston, TX vs other payment areas
  1. Houston, TX · this page$235.45
  2. Austin, TX · Texas$238.69+$3.24
  3. Beaumont, TX · Texas$217.59−$17.86
  4. Brazoria, TX · Texas$228.19−$7.26
  5. Dallas, TX · Texas$229.90−$5.55
  6. Fort Worth, TX · Texas$228.60−$6.85
  7. Galveston, TX · Texas$229.04−$6.41

Other areas in Texas first, then benchmark localities. Bars start at $0.

Every other payment area

23065 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$222.94$142.43
Los Angeles, CACalifornia$257.14$156.77
Washington, DC areaDistrict of Columbia$262.63$162.69
Miami, FLFlorida$255.29$166.97
Chicago, ILIllinois$247.86$162.59
Manhattan, NYNew York$266.59$168.01
AlaskaAlaska$273.05$182.70
AlabamaAlabama$208.27$134.04

23065 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$205.36

$273.05

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
23065 office rate range by state
State / territoryOffice rate rangeLocalities
AK$273.051
AL$208.271
AR$205.361
AZ$225.291
CA$241.23–$298.3529
CO$239.081
CT$246.581
DC$262.631
DE$228.921
FL$230.97–$255.293
GA$218.06–$236.362
GU$246.411
HI$246.411
IA$212.101
ID$213.711
IL$225.44–$247.864
IN$214.881
KS$211.751
KY$214.381
LA$214.31–$224.512
MA$237.98–$261.372
MD$233.00–$262.633
ME$215.45–$225.852
MI$220.36–$234.412
MN$227.441
MO$211.16–$224.533
MS$208.271
MT$231.441
NC$217.541
ND$224.521
NE$213.031
NH$235.951
NJ$248.93–$260.172
NM$221.791
NV$229.661
NY$220.75–$273.675
OH$218.951
OK$213.351
OR$227.42–$245.762
PA$218.94–$241.012
PR$232.891
RI$236.411
SC$218.701
SD$223.711
TN$212.861
TX$217.59–$238.698
UT$221.581
VA$225.57–$262.632
VI$232.891
VT$224.241
WA$237.33–$265.982
WI$217.291
WV$217.521
WY$228.431

See 23065 in every payment locality

How the 23065 rate is calculated

Each of 23065’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 23065

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.24

2.24 RVUs× 1.000 GPCI

Practice expense4.34

4.34 RVUs× 1.000 GPCI

Malpractice0.35

0.35 RVUs× 1.000 GPCI

Adjusted RVUs

6.9300

Conversion factor

$33.4009

Medicare rate

$231.47

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,155

Code
23065
Physician work
2.24
Practice expense
4.34
Malpractice
0.35

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 23065 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work2.24× 1.0082.2579
Practice expense4.34× 0.9934.3096
Malpractice0.35× 1.3760.4816
Total RVUs7.0491
Conversion factor× 33.4009

Office rate, Houston, TX$235.45

Office: (2.24 × 1.008 + 4.34 × 0.993 + 0.35 × 1.376) × $33.4009 = $235.45

Facility: (2.24 × 1.008 + 1.8 × 0.993 + 0.35 × 1.376) × $33.4009 = $151.20

Open 23065 in the RVU calculator

Payment rules and modifiers for 23065

23065 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23065

Shoulder biopsy, deep soft tissue

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 23065

Shoulder biopsy, deep soft tissue

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

23065 without 50 · national office

$231.47

Shoulder biopsy, deep soft tissue

23065-50 · Bilateral: 150%

$347.21

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 23065

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 23065
CodeHow it relatesOffice range, Houston, TX
Used instead
23066Shoulder biopsy, deep tissueShoulder-region biopsy when the sampled target is bone rather than deep soft tissue.$635.09
20206Muscle biopsy, percutaneous needle approachPercutaneous needle biopsy of muscle when that method and target are appropriate.$210.18
23071Shoulder mass excision, subcutaneous, 3 cm or largerShoulder-region subcutaneous lesion excision when complete removal, not biopsy, is performed.No office rate
23075Shoulder excision, subcutaneous, under 3 cmShoulder-region excision of a small subcutaneous lesion rather than deep soft-tissue sampling.$564.73
23073Shoulder tumor excision, deep, 5 cm or largerComplete excision of a qualifying deep shoulder soft-tissue tumor rather than biopsy.No office rate
23076Shoulder tumor excision, deep, under 5 cmComplete excision of a smaller deep shoulder soft-tissue tumor rather than biopsy.No office rate

How 23065 has changed in Houston, TX

23065 · Office / nonfacility

$235.45

Effective 2026-10-01

The base rate is $10.39 higher than on 2025-10-01, moving from $225.06 to $235.45 (4.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $225.06changed to$235.45

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.30 changed to 2.24
    • Practice expense RVU 4.12 changed to 4.34
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $232.94changed to$225.06

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.16 changed to 4.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $229.14changed to$232.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $234.88changed to$229.14

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.12 changed to 4.16
    • Malpractice RVU 0.34 changed to 0.35
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $239.84changed to$234.88

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.14 changed to 4.12
    • Malpractice RVU 0.33 changed to 0.34
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $239.72changed to$239.84

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.09 changed to 4.14
    • Malpractice RVU 0.32 changed to 0.33

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $234.21changed to$239.72

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.77 changed to 4.09
    • Malpractice RVU 0.31 changed to 0.32
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $230.91changed to$234.21

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.68 changed to 3.77
    • Malpractice RVU 0.36 changed to 0.31
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $226.67changed to$230.91

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.58 changed to 3.68
    • Malpractice RVU 0.35 changed to 0.36

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $224.97changed to$226.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.55 changed to 3.58
    • Malpractice RVU 0.36 changed to 0.35
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $223.71changed to$224.97

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.53 changed to 3.55
    • Malpractice RVU 0.37 changed to 0.36
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $223.09changed to$223.71

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.50 changed to 3.53
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $221.98changed to$223.09

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $219.74changed to$221.98

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.45 changed to 3.50
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $224.19changed to$219.74

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.91 changed to 3.45
    • Malpractice RVU 0.38 changed to 0.36
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $224.19

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$235.45$151.20RVU26D
2026-07-01$235.45$151.20RVU26C
2026-04-01$235.45$151.20RVU26B
2026-01-01$235.45$151.20RVU26A
2025-10-01$225.06$162.12RVU25D
2025-07-01$225.06$162.12RVU25C
2025-04-01$225.06$162.12RVU25B
2025-01-01$225.06$162.12RVU25A
2024-10-01$232.94$166.83RVU24D
2024-07-01$232.94$166.83RVU24C
2024-04-01$232.94$166.83RVU24B
2024-03-09$232.94$166.83RVU24AR
2024-01-01$229.14$164.11RVU24A
2023-10-01$234.88$166.36RVU23D
2023-07-01$234.88$166.36RVU23C
2023-04-01$234.88$166.36RVU23B
2023-01-01$234.88$166.36RVU23A
2022-10-01$239.84$167.56RVU22D
2022-07-01$239.84$167.56RVU22C
2022-04-01$239.84$167.56RVU22B
2022-01-01$239.84$167.56RVU22A
2021-10-01$239.72$169.35RVU21D
2021-07-01$239.72$169.35RVU21C
2021-04-01$239.72$169.35RVU21B
2021-01-01$239.72$169.35RVU21A
2020-10-01$234.21$172.74RVU20D
2020-07-01$234.21$172.74RVU20C
2020-04-01$234.21$172.74RVU20B
2020-01-01$234.21$172.74RVU20A
2019-10-01$230.91$175.11RVU19D
2019-07-01$230.91$175.11RVU19C
2019-04-01$230.91$175.11RVU19B
2019-01-01$230.91$175.11RVU19A
2018-10-01$226.67$175.31RVU18D
2018-07-01$226.67$175.31RVU18C
2018-04-01$226.67$175.31RVU18B
2018-01-01$226.67$175.31RVU18AR1
2017-10-01$224.97$175.00RVU17D
2017-07-01$224.97$175.00RVU17C
2017-04-01$224.97$175.00RVU17B
2017-01-01$224.97$175.00RVU17A
2016-10-01$223.71$174.01RVU16D
2016-07-01$223.71$174.01RVU16C
2016-04-01$223.71$174.01RVU16B
2016-01-01$223.71$174.01RVU16A
2015-10-01$223.09$173.57RVU15D
2015-07-01$223.09$173.57RVU15C
2015-04-01$221.98$172.71RVU15B
2015-01-01$221.98$172.71RVU15A
2014-10-01$219.74$171.54RVU14D
2014-07-01$219.74$171.54RVU14C
2014-04-01$219.74$171.54RVU14B
2014-01-01$219.74$171.54RVU14A
2013-10-01$224.19$172.03RVU13D
2013-07-01$224.19$172.03RVU13C
2013-04-01$224.19$172.03RVU13B
2013-01-01$224.19$172.03RVU13AR

Price 23065 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

23065 billing questions

How is this code distinguished from 23066?

This code is for a deep soft-tissue biopsy in the shoulder region. Use 23066 when the biopsy target is bone.

Should this code be used when the entire mass is removed?

No. It represents sampling for diagnosis, not complete lesion excision. For a complete excision, select the applicable shoulder excision code based on tissue depth and lesion size.

What documentation supports reporting this biopsy?

Document the shoulder-region target, that it is deep soft tissue, the biopsy approach, and the tissue sampled. The operative record should make clear that tissue was obtained for diagnosis rather than the lesion being completely excised.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in this procedure's payment.

How does Medicare handle bilateral biopsies or another procedure in the same session?

A bilateral procedure reported with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are reduced to 50%.

Can an assistant or another surgeon be reported for this procedure?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 23065PPRRVU2026_Oct_nonQPP.csv, line 2,155 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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